Shunt (CNS) infection: (VA / VP shunt); EVD (external ventricular drain) or lumbar drain (LD)

ceftazidime 2g iv tds (if patient is over 80 years of age the usual daily maximum dose of ceftazidime is 3g; this can be increased to 6g daily on advice documented by ID Micro Consultant)

AND

linezolid 600mg po (iv if NBM) bd (See linezolid drug monograph for information about monitoring required)

If unable to have linezolid: substitute linezolid with vancomycin iv

For penicillin allergy (severe)

ciprofloxacin* 400mg iv bd (500mg po bd). Ciprofloxacin may induce seizures in patients with or without a history of seizures – use with caution

AND

linezolid 600mg po (iv if NBM) bd (See linezolid drug monograph for information about monitoring required)

If unable to have linezolid: substitute linezolid with vancomycin iv

*Ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.

Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially long-lasting or irreversible side effects. See Fluoroquinolone antibiotics - severe adverse effects. 

ceftazidime  2g iv tds  (Note: if patient is over 80 years of age the usual daily maximum dose of ceftazidime is 3g; this can be increased to 6g daily on advice documented by ID Micro Consultant)

AND

linezolid 600mg po (iv if NBM) bd (See linezolid drug monograph for information about monitoring required)

If unable to have linezolid: substitute linezolid with vancomycin iv

Consider adding: vancomycin 10 mg od intrathecally administered

Choices should be guided by susceptibility results and after discussion with Adult or Paeds ID team

For dosing - always discuss with Micro/ID